EDITORIAL: Work isn’t over on fixing Idaho health care

Times-News (Twin Falls, ID)

Feb. 15--When Donald J. Trump won the presidential election in the fall, you could almost hear the death knell for health care reform in Idaho.

With national Republicans pledging to dismantle the Affordable Care Act, state lawmakers saw no reason to try to come up with a new Idaho program. The feds would almost certainly revamp health care, they thought, so no sense in designing something new that might not jive with whatever comes out of Washington. Better to wait.

But that's not what's happening now in the Idaho Statehouse. Just this week, Republicans have introduced two similar bills that aren't necessarily fix-alls -- as we've said before, expanding Medicaid is the best solution -- but go a long way toward addressing health care needs for some of the state's most vulnerable residents.

So what's changed? Why now?

First, the Trump administration and congressional Republicans aren't acting as fast as people thought they might to dismantle Obamacare, mostly because they still haven't settled on a plan to replace it.

Second, real human beings in Idaho continue to suffer because there is no viable state solution to their health care problems. We're talking mostly about the people in the so-called gap, who make too much money to qualify for Medicaid but not enough to get subsidies to join the government health insurance exchange. That amounts to about 78,000 people, some of whom are likely to die this year because they can't afford to seek treatment for preventable diseases.

Rep. Fred Wood, a Burley Republican, is one lawmaker who hasn't given up on those folks. Wood's bill, introduced Monday, would cover people with incomes below the poverty level who are not covered by any other government or employer-sponsored health care.

On the Senate side, lawmakers are reviewing a similar proposal by Sen. Steven Thayn, R-Emmett. His bill would also provide primary care with money from the Millennium Fund, the account set up to handle settlements with the big tobacco companies. But Thayn wants to focus on patients with chronic conditions.

Wood's plan is more broad, serving people on a first-come, first-served basis regardless of condition. Wood said his plan would also help to further the state's goal of moving away from a "volume based, fee-for-service model to a value-based system of care," because it focuses on treating patients with primary care -- a model that helps to prevent health problems, not just treat them once they've happened.

We still regret Idaho didn't expand Medicaid when it had the chance. As a result, it's missing out on millions of federal dollars a year that could easily go toward these residents the state is now trying to protect. And we're especially frustrated the Legislature didn't act last year, after squabbling about health care the entire session and scrapping a plan by Gov. C.L. "Butch" Otter only to break on the last day without a fix.

It's unlikely lawmakers will find a perfect solution this session. Far too many legislators still lack the guts to adopt federal solutions because of the weird paranoia of anything federal that still permeates the Statehouse.

But we're encouraged legislators like Wood haven't given up.

So let's celebrate and recognize the small victories when they happen. Wood and Thayn are on to something. Let's hope other lawmakers see their wisdom and continue to work the problem.

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